Abundant Life Center Iih & MHSS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ABUNDANT LIFE CENTER IIH & MHSS

Practice address

4222 Bonniebank Rd #304
Richmond, VA 23234

Phone

(804) 399-7108

Fax

(804) 293-0857

NPI assigned

Aug 25, 2010

Last updated

Oct 29, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tonya Denise Prince, MSW

Title

Owner

Phone

(804) 399-7108

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1184930463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 BONNIEBANK RD #304",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23234",
            "telephone_number": "804-399-7108",
            "fax_number": "804-293-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 BONNIEBANK RD #304",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23234",
            "telephone_number": "804-399-7108",
            "fax_number": "804-293-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT LIFE CENTER IIH & MHSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-399-7108",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "895-03-001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.